National Disaster Preparedness Research Articles

National disaster preparedness and emergency response of nurses in Germany: An exploratory qualitative study

Aim: This study aimed to explore the German nurses’ perceptions of their knowledge, roles and experience in the field of national preparedness and emergency response. Methods: An exploratory qualitative design was used with open-ended questions during semi-structured interviews with qualified nurses currently working in hospitals. The setting of the study consisted of wards of different hospitals in three northern federal states of Germany. The data analysis was done by summarizing analysis of the contents. From a convenient sample of n=31 hospitals, n=13 nurses were included in the study. Results: The median age of the participants was 45 years and 38% were female. Within the three professional socialization fields, knowledge, roles and experience, 17 themes were clustered. Conclusion: Within the themes of knowledge, role and experience in national disaster prepared-ness and emergency response, similarities and differences were explored in comparison to inter-national literature.

Nurses’ roles, knowledge and experience in national disaster pre-paredness and emergency response: A literature review

Aim: Nurses play a central role in disaster preparedness and management, as well as in emergency response, in many countries over the world. Care in a disaster environment is different from day-to-day nursing care and nurses have special needs during a disaster. However, disaster nursing education is seldom provided and a lack of curricula exists in many countries around the world. The aim of this literature review is to provide an overview of nurses’ roles, knowledge and experience in national disaster preparedness and emergency response. Methods: An electronic search was conducted using multiple literature databases. All items were included, regardless of the publication year. All abstracts were screened for relevance and a synthesis of evidence of relevant articles was undertaken. Relevant information was extracted, summarized and categorized. Out of 432 reviewed references, information of 68 articles was included in this review. Results: The sub-themes of the first main theme (a) roles of nurses during emergency response include the expectations of the hospital and the public, general and special roles of nurses, assignments of medical tasks, special role during a pandemic influenza, role conflicts during a disaster, willingness to respond to a disaster. For (b) disaster preparedness knowledge of nurses, the corresponding sub-themes include the definition of a disaster, core competencies and curriculum, undergraduate nursing education and continuing education programs, disaster drills, training and exercises, preparedness. The sub-themes for the last theme (c) disaster experiences of nurses include the work environment, nursing care, feelings, stressors, willingness to respond as well as lessons learned and impacts. Conclusion: There is consensus in the literature that nurses are key players in emergency response. However, no clear mandate for nurses exists concerning their tasks during a disaster. For a nurse, to be able to respond to a disaster, personal and professional preparedness, in terms of education and training, are central. The Framework of Disaster Nursing Competencies of the WHO and ICN, broken down into national core competencies, will serve as a sufficient complement to the knowledge and skills of nurses already acquired through basic nursing curricula. During and after a disaster, attention should be applied to the work environment, feelings and stressors of nurses, not only to raise the willingness to respond to a disaster. Where non-existent, national directives and concepts for disaster nursing should be developed and nurses should be aware of their duties. Nursing educators should prepare nurses for disasters, by adjusting the curricula and by meeting the increased need for education and training in disaster nursing for all groups of nurses. The appropriateness of theoretical and practical preparation of disaster nursing competencies in undergraduate nursing courses and continuing education programmes should be evaluated.

Understanding of environmental pollution and its anthropogenic impacts on biological resources during the COVID-19 period.

The global outbreak of the COVID-19 pandemic has given rise to a significant health emergency to adverse impact on environment, and human society. The COVID-19 post-pandemic not only affects human beings but also creates pollution crisis in environment. The post-pandemic situation has shown a drastic change in nature due to biomedical waste load and other components. The inadequate segregation of untreated healthcare wastes, chemical disinfectants, and single-use plastics leads to contamination of the water, air, and agricultural fields. These materials allow the growth of disease-causing agents and transmission. Particularly, the COVID-19 outbreak has posed a severe environmental and health concern in many developing countries for infectious waste. In 2030, plastic enhances a transboundary menace to natural ecological communities and public health. This review provides a complete overview of the COVID-19 pandemic on environmental pollution and its anthropogenic impacts to public health and natural ecosystem considering short- and long-term scenarios. The review thoroughly assesses the impacts on ecosystem in the terrestrial, marine, and atmospheric realms. The information from this evaluation can be utilized to assess the short-term and long-term solutions for minimizing any unfavorable effects. Especially, this topic focuses on the excessive use of plastics and their products, subsequently with the involvement of the scientific community, and policymakers will develop the proper management plan for the upcoming generation. This article also provides crucial research gap knowledge to boost national disaster preparedness in future perspectives.

Understanding the teachers' disaster preparedness beliefs

This study investigated the extent of teachers' disaster preparedness beliefs regarding perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy and how their beliefs change concerning their demographic characteristics. The sample included 19,723 respondents who participated in the School-Based Disaster Education-Teacher Training Program of the Turkish Ministry of National Education. The results showed that teachers' preparatory beliefs, especially those associated with their perceived benefits, susceptibility, barriers, and self-efficacy, were high, whereas their beliefs were found as moderate and low levels in cues to action and perceived severity dimensions. Age, disaster education experience, and gender were found to be significant variables related to teachers' disaster preparation beliefs. However, respondents' residential areas do not show different beliefs since all regions of Turkiye are prone to short lead-time disasters. These findings can guide policymaking and interventions to promote national disaster preparedness and develop a more effective and tailor-made teacher training program.

Prevalence of Depression and Posttraumatic Stress Disorder in Flint, Michigan, 5 Years After the Onset of the Water Crisis

Environmental disasters, such as the Flint, Michigan, water crisis, are potentially traumatic events (PTEs) that may precipitate long-term psychiatric disorders. The water crisis was associated with acute elevations in mental health problems in the Flint community, but long-term psychiatric sequelae have not yet been evaluated using standardized diagnostic measures. To investigate the prevalence of and factors associated with current presumptive diagnostic-level major depression and posttraumatic stress disorder (PTSD) among Flint residents 5 years after the onset of the crisis. In this cross-sectional study, a household probability sample of 1970 adults living in Flint, Michigan, during the crisis were surveyed about their crisis experiences, their psychological symptoms 5 years later, and their access to and use of mental health services in the intervening years. Analyses were weighted to produce population-representative estimates. Presumptive Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) diagnostic-level past-year major depression and PTSD. Among 1970 respondents, 1061 of 1946 reporting sex (54.5%) were women; 1043 of 1951 reporting race (53.5%) were Black or African American and 829 (42.5%) were White; and 1895 of 1946 reporting ethnicity (97.4%) were non-Hispanic. Overall, 435 (22.1%) met DSM-5 criteria for presumptive past-year depression, 480 (24.4%) for presumptive past-year PTSD, and 276 (14.0%) for both disorders. Residents who believed that their or their family's health was harmed by contaminated water (eg, risk ratio [RR] for depression: 2.23; 95% CI, 1.80-2.76), who had low confidence in public-official information (eg, RR for PTSD, 1.44; 95% CI, 1.16-1.78), who had previous exposure to PTEs (eg, RR for both disorders: 5.06; 95% CI, 2.99-8.58), or who reported low social support (eg, RR for PTSD, 2.58; 95% CI, 1.94-3.43) had significantly higher risk for depression, PTSD, and comorbidity. PTEs involving prior physical or sexual assault were especially potent risk factors (eg, both disorders: RR, 7.30; 95% CI, 4.30-12.42). Only 685 respondents (34.8%) were ever offered mental health services to assist with water-crisis-related psychiatric symptoms; most (543 [79.3%]) who were offered services utilized them. In this cross-sectional study of psychiatric disorder in Flint, Michigan, presumptive depression and PTSD were highly prevalent 5 years after the onset of the water crisis. These findings suggest that public-works environmental disasters have large-scale, long-term psychological sequelae. The Flint community may require expanded mental health services to meet continued psychiatric need. National disaster preparedness and response programs should consider psychiatric outcomes.

Spatiotemporal climate variability and meteorological drought characterization in Ethiopia

Increasing drought patterns with profound effects on livelihoods and food security have been documented in Ethiopia. From previous studies', assessments at various timescales, Ethiopia is regarded as a drought-prone country in East Africa. However, there is no documentation available. This paper investigates the spatiotemporal patterns of drought characteristics in 16 woredas (districts) as well as in the 14 homogeneous rainfall zones of homogeneous using monthly rainfall and temperature data over the period 1983 to 2020. The Standardized Precipitation Index (SPI) and Standardized Precipitation Evapotranspiration Index (SPEI) were computed using time-series meteorological data to depict the spatial extent of drought characteristics and patterns at 4- and 12-month timescales. Within the period investigated, 12-month, 2015, and 2019 recorded the most extreme countrywide drought. The most prolonged drought duration lasted for 12 months in 2015. Although Ethiopia is a drought-prone country, the frequency, magnitude, and severity vary spatially by region. In planning for future actions, particular emphasis must be paid to the northeastern, eastern, northwestern, and southeastern parts of the country, which are more vulnerable. The findings could potentially influence and redirect national drought management and disaster preparedness programs for the affected areas.

Response Efficacy Perception and Taking Action to Prepare for Disasters with Different Lead Time

This study investigated how disaster types, namely those with shorter and longer warning lead times, contextualized individuals’ preparatory actions, especially those associated with their response efficacy perception (i.e., the belief that preparations are effective in risk reduction) and age. The working sample included 1,304 respondents from the 2017 US National Household Survey. Logistic regressions showed that individuals with higher levels of response efficacy perception were more likely to prepare after learning information about how to prepare. Respondents in areas prone to short lead-time disasters were less likely to prepare than those in areas exposed to longer lead-time disasters. Response efficacy perception was more important for taking action to prepare for short lead-time disasters, which was observed only among older adults but not among younger adults. These findings revealed the impacts of disaster types and response efficacy perception on disaster preparedness and older adults’ unique vulnerability and resilience, which could guide policymaking and interventions to promote national disaster preparedness tailored to regional peculiarities.

Response Efficacy and Action to Prepare for Disasters With Different Lead Time: Age Differences

This study investigated how disaster types, namely those with short and longer warning lead time, contextualized individuals’ preparatory action, especially as associated with their response efficacy and age. The working sample included 1,467 respondents from the 2017 U.S. National Household Survey. Logistic regressions showed that individuals with higher levels of response efficacy were more likely to prepare after learning information about how to prepare. Respondents in areas prone to short lead-time disasters were less likely to prepare than those in longer lead-time disasters areas. Response efficacy was more important for action taking for short lead-time disasters, which was observed only among older adults when older and younger adults were examined separately. These findings revealed the impacts of disaster types and response efficacy on disaster preparedness and older adults’ unique vulnerability and resilience, which could guide policymaking and interventions to promote national disaster preparedness tailored to regional peculiarities.

Household emergency preparedness: A multidisciplinary concept analysis.

Household emergency preparedness, at the individual and family micro-level, is often identified as below national disaster preparedness standards. Conceptual clarity of household emergency preparedness is foundational for disaster preparedness research, theory construction, and instrument use. Adhering to Walker and Avant's (2019) concept analysis method, the purpose of this paper is to outline the concept of household emergency preparedness by identifying the uses of the concept, the defining attributes, antecedents, consequences, and empirical referents. Literature sources were identified using the Cumulative Index for Nursing and Allied Health (CINAHL), ProQuest Central, PsycInfo, PubMed, and government websites. Concept clarification is critical for future selection of research designs involving multidisciplinary community-based interventions for household emergency preparedness, as well as to understand how preparedness efforts at the individual and family micro-level may influence larger disaster preparedness system outcomes.

Challenges and actions to the environmental management of Bio-Medical Waste during COVID-19 pandemic in India

The outbreak of COVID-19 has engendered a global health crisis along with diverse impacts on economy, society and environment. Efforts to combat this pandemic have also significantly shot-up the quantity of Bio-medical Waste (BMW) generation. Safe disposal of large quantity of BMW has been gradually posing a major challenge. BMW management is mostly implemented at municipal level following regulatory guidelines defined by respective states and the Union. This article is a narrative of the status of BMW generation, management and regulation in India in the context of COVID-19 crisis. The article is based on comparative analysis of data on BMW generation and management from authentic sources, a systematic literature review and review of news reports. In the current pandemic situation where media has been playing a significant role in highlighting all the concerns related to COVID-19 spread and management. Assessing the ground situation regarding effectiveness of prevailing BMW management facilities, requirement and suggestions can provide insights to the subject with policy implications for India and countries as well. The discussion has been built on different dimensions of BMW management during the pandemic including existing infrastructures, capacity utilisation, policy guidelines, operational practices and waste-handlers aspects. The results on state-wise analysis of reported BMW quantity and active COVID-19 patients also reveal some non-linear relationship between the two variables. Delhi, the National Capital is situated at a better position in terms of BMW management as compared to other studied states. The findings are expected to provide valuable insights to the policy makers and other relevant authorities to evaluate adequateness as well as efficiency quotients of entire BMW management landscape. Some of the critical observations of this article are also expected to offer impetus for enhancing national disaster preparedness in future.

Management Of Chronic Noncommunicable Diseases After Natural Disasters In The Caribbean: A Scoping Review.

Extreme weather events in the Caribbean region are becoming increasingly severe because of climate change. The region also has high rates of poorly controlled chronic noncommunicable diseases (NCDs), which were responsible for at least 30percent of deaths after two recent hurricanes. We conducted a scoping review of literature published between 1974 and 2020 to understand the burden and management of chronic NCDs in the Caribbean after natural disasters. Of the twenty-nine articles included in this review, most described experiences related to Hurricanes Dorian (2019) and Irma and Maria (2017) and the Haiti earthquake (2010). Challenges included access to medication, acute care services, and appropriate food, as well as communication difficulties and reliance on ad hoc volunteers and outside aid. Mitigating these challenges requires different approaches, including makeshift points of medication dispensing, disease surveillance systems, and chronic disease self-management education programs. Evidence is needed to inform policies to build resilient health systems and integrate NCD management into regional and national disaster preparedness and response plans.

Recruiting students for the COVID-19 emergency response: lessons from eight African countries

Background: This paper examines how African countries can innovatively use pre-qualified undergraduate and postgraduate students, as well as retired clinical, laboratory and epidemiological technocrats in dealing with medical emergency situations, such as the COVID-19 pandemic. Methods: An online questionnaire was sent to key informants in six universities and two research institutions working with the Tackling Infections to Benefit Africa (TIBA) program eight African countries. The return rate was 88.9% and data was analysed using the framework method. Results: Students and other personnel trained in the medical and health professions are a valuable resource that can be mobilised by African governments during medical emergency situations. These are found in research, academia, non-governmental organisations, and government. However, without clear plans and mechanisms for recruiting, supervising and remunerating or reimbursing the costs of engaging someone not employed by the government, the legitimation and authority for such recruitment becomes a challenge. Currently, postgraduate students in the biomedical sciences are the most preferred because of their level of experience and exposure to medical techniques. They also have a degree certificate, which serves as a quality and competence assurance tool. Engagement of postgraduate medical students undergoing their residence programmes also seems a lot easier. While on the other hand, undergraduate students, who are the majority, are considered underexposed and with low technological capabilities. They also lack certificates needed to ensure competence, although we argue that not all tasks during pandemics require specialized skills. Conclusion: As a step towards strengthening national disaster preparedness capacities, African governments need to develop plans that clarify protocols for engaging, training, supervising and protecting students, especially undergraduates and those taking non-biomedical courses. Such plans may form part of the National Pandemic Response Plan, while considering both specialised and non-specialized roles of emergency response.

Disaster preparedness for earthquakes in hemodialysis units in Gyeongju and Pohang, South Korea.

In 2016 and 2017, there were earthquakes greater than 5.0 in magnitude on the Korean Peninsula, which has previously been considered an earthquake-free zone. Patients with chronic kidney disease are particularly vulnerable to earthquakes, as the term “renal disaster” suggests. In the event of a major earthquake, patients on hemodialysis face the risk of losing maintenance dialysis due to infrastructure disruption. In this review, we share the experience of an earthquake in Pohang that posed a serious risk to patients on hemodialysis. We review the disaster response system in Japan and propose a disaster preparedness plan with respect to hemodialysis. Korean nephrologists and staff in dialysis facilities should be trained in emergency response to mitigate risk from natural disasters. Dialysis staff should be familiar with the action plan for natural disaster events that disrupt hemodialysis, such as outages and water treatment system failures caused by earthquakes. Patients on hemodialysis also need to be educated about disaster preparedness. In the event of a disaster situation that results in dialysis failure, patients need to know what to do. At the local and national government level, long-term preparations should be made to handle renal disaster and patient safety logistics. Moreover, Korean nephrologists should also be prepared to manage cardiovascular disease and diabetes in disaster situations. Further evaluation and management of social and national disaster preparedness of hemodialysis units to earthquakes in Korea are needed.

Trauma Anesthesiology as Part of the Core Anesthesiology Residency Program Training: Expert Opinion of the American Society of Anesthesiologists Committee on Trauma and Emergency Preparedness (ASA COTEP).

Trauma Anesthesiology as Part of the Core Anesthesiology Residency Program Training: Expert Opinion of the American Society of Anesthesiologists Committee on Trauma and Emergency Preparedness (ASA COTEP).

Review of Recent Large-Scale Burn Disasters Worldwide in Comparison to Preparedness Guidelines.

The US National Bioterrorism Hospital Preparedness Program indicates that each care facility must have "a plan to care for at least 50 cases per million people for patients suffering burns or trauma" to receive national funding disaster preparedness. The purpose of this study is to evaluate whether this directive is commensurate with the severity recent burn disasters, both nationally and internationally. We conducted a review of medical journal articles, investigative fire reports, and media news sources for major burn disasters dating from 1990 to present day. We defined a major burn disaster as any incident with ≥50 burn injuries and/or ≥ 30 burn-related deaths. We compared existing preparedness guidelines with the magnitude of recent burn disasters using as reference the 2005 U.S. Health and Human Services directive that each locale must "have a plan to care for at least 50 cases per million people for patients suffering burns or trauma." We reported the number of actual casualties for each incident, and estimated the number of burn beds theoretically available if the "50 [burn-injury] cases per million people" directive were to be applied to metropolitan areas outside the United States. Seven hundred fifty-two burn disaster incidents met our inclusion criteria. The majority of burn disasters occurred in Asia/Middle East. The incidence of major burn disasters from structural fires and industrial blasts remains constant in high-income and resource-restricted countries during this study period. The incidence of terrorist attacks increased 20-fold from 2001 to 2015 compared with 1990 to 2000. Recent incidents demonstrate that if current preparedness guidelines were to be adopted internationally, local resources including burn-bed availability would be insufficient to care for the total number of burn casualties. These findings underscore an urgent need to organize better regional, national, and international collaboration in burn disaster response.

Liberia national disaster preparedness coordination exercise: Implementing lessons learned from the West African disaster preparedness initiative.

In light of the recent Ebola outbreak, there is a critical need for effective disaster management systems in Liberia and other West African nations. To this end, the West Africa Disaster Preparedness Initiative held a disaster management exercise in conjunction with the Liberian national government on November 24-25, 2015. During this tabletop exercise (TTX), interactions within and between the 15 counties and the Liberian national government were conducted and observed to refine and validate the county and national standard operating procedures (SOPs). The exercise took place in three regional locations throughout Liberia: Monrovia, Buchanan, and Bong. The TTX format allowed counties to collaborate utilizing open-source software platforms including Ushahidi, Sahana, QGIS, and KoBoCollect. Four hundred sixty-seven individuals (representing all 15 counties of Liberia) identified as key actors involved with emergency operations and disaster preparedness participated in the exercise. A qualitative survey with open-ended questions was administered to exercise participants to determine needed improvements in the disaster management system in Liberia. Key findings from the exercise and survey include the need for emergency management infrastructure to extend to the community level, establishment of a national disaster management agency and emergency operations center, customized local SOPs, ongoing surveillance, a disaster exercise program, and the need for effective data sharing and hazard maps. These regional exercises initiated the process of validating and refining Liberia's national and county-level SOPs. Liberia's participation in this exercise has provided a foundation for advancing its preparedness, response, and recovery capacities and could provide a template for other countries to use.

India - National disaster and epidemic preparedness

History provides us several illustrations where epidemic outbreaks have led to biological disasters. Accidental or deliberate release of harmful micro-organisms can also lead to biological disasters. With the advent of bio-terrorism, there is a growing realisation that biological agents can also be used as weapons of mass destruction. The spread of Spanish Influenza of 1917-18, the Human Immunodeficiency Virus (HIV) / Acquired Immuno Deficiency Syndrome (AIDS), Severe Acute Respiratory Syndrome (SARS), Swine Flu (H1N1), Avian Influenza (H5N1), Middle East Respiratory Syndrome (MERS), dengue, chikunguniya, Ebola outbreak in West Africa and the recent Zika outbreak in several countries tested the capacities of the public health delivery system in several countries.

The Disaster Preparedness Program: a new model for sustainable capacity building through civil-military collaboration

Abstract Background The Disaster Preparedness Program (DPP) is a partnership between The Center for Disaster and Humanitarian Assistance Medicine (CDHAM)—a part of the Uniformed Services University of the Health Sciences—and the United States Africa Command (USAFRICOM). The DPP aims to assist African partner nations to enhance their disaster preparedness and response capabilities. The programme takes a whole-of-government approach to disaster preparedness and response, with an emphasis on plan development and, in some cases, creation of an autonomous national disaster management agency. Methods The DPP worked with the Embassy and other US government stakeholders to identify key ministries involved in disaster preparedness. With DPP assistance, a technical team from the partner nation undertook a comprehensive assessment of their current disaster response capabilities. This information was used to construct a disaster management strategic work plan that identified specific gaps in disaster preparedness. A disaster simulation exercise was conducted with representatives from agencies and ministries involved in disaster response. They applied their existing structure, plans and resources to a scenario designed for their country by CDHAM in order to identify any additional shortfalls in the plan. The finalised work plan could then be used by the partner nation to prioritise and address immediate needs. Findings Since 2009, CDHAM has worked with 16 partner nations. Ten countries have developed national pandemic influenza preparedness and response plans. By December, 2014, one country had used this plan to prevent the spread of Ebola, one country adapted this plan to a whole-of-government Ebola response, and six others are currently in the process of adopting this approach. Eight African armies have drafted military support to civil authorities disaster contingency plans, and one army has used this approach with Ebola. Ten countries have developed disaster management strategic work plans and are currently conducting activities in partnership with the US State Partnership Program, USAFRICOM, the Defense Threat Reduction Agency and the World Bank to fill gaps in their national disaster preparedness. Interpretation Although the work with the DPP is expected to enhance partner nations' preparedness and response to disasters, measuring the outcomes of these projects may take several years. The next phase of the DPP will focus on sustained support to local programmes while working with them to assess improvements in their response capabilities. As a result of these successful partnerships, CDHAM is now also playing a major role in assisting west African partner nations with Ebola preparedness activities. Funding Initially provided through USAID, but funding is now provided through the Defense Security Cooperation Agency's Overseas Humanitarian, Disaster, and Civic Aid.

Minimum initial service package (MISP) for sexual and reproductive health in disasters.

This paper is based on a presentation given at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. The paper provides background about how the sexual and reproductive health (SRH) got conceived as a humanitarian health response that adopts human right approach, based on core principles driven by needs of adolescent girls and women, and having respect for their values, ethics and morals. Good practices across nations documented by Inter-Agency Working Groups (IAWGs) on Reproductive Health in Humanitarian Crisis has supported the provision of essential SRH care services to adolescent girls and women in humanitarian crisis and in disasters. Secondary desk review is used to document the lessons learnt and good practices followed and documents for SRH. These essential SRH care services are to be provided as "Minimum Initial Service Package (MISP)" for implementation at the outset of disaster. The Sphere Humanitarian Charter and Minimum Standards in Disaster Response incorporated the MISP for SRH as a minimum standard of care in disaster response with a goal to reduce mortality, morbidity and disability among populations affected by crises, particularly women and girls. Disaster prone countries are expected to roll out MISP to improve humanitarian response and emergency preparedness systems. The East Europe and Central Asia (EECA) region including India have rolled out MISP starting from 2011 (EECA) and from 2013-2014 onwards in India across cities such as Chennai, Patna, Bhubaneshwar, Kolkata, Faridabad and Calcutta. Across India, through these national and state level trainings, nearly 600 people from NGOs, institutions, and government agencies were developed as national level trainers and resource persons for MISP who could advocate for RH in emergencies, apply core techniques provided in the MISP, apply coordination skills for the implementation of MISP and develop an action plan to integrate RH and Gender Based Violence (GBV) into Disaster Management Plans of respective agencies. The way forward includes focusing on MISP distance learning module, integration of MISP in Health action plans, and integration into national disaster preparedness and contingency planning of respective agencies and departments and building capacity at various levels.

Disaster Preparedness in an Australian Urban Trauma Center: Staff Knowledge and Perceptions

A substantial barrier to improving disaster preparedness in Australia is a lack of prescriptive national guidelines based on individual hospital capabilities. A recent literature review revealed that only one Australian hospital has published data regarding its current preparedness level. To establish baseline levels of disaster knowledge, preparedness, and willingness to respond to a disaster among one hospital's staff, and thus enable the implementation of national disaster preparedness guidelines based on realistic capabilities of individual hospitals. An anonymous questionnaire was distributed to individuals and departments that play key roles in the hospital's external disaster response. Questions concerned prior education and experience specific to disasters, general preparedness knowledge, perceived preparedness of themselves and their department, and willingness to respond to a disaster from a conventional and/or chemical, biological, or radiological incident. Responses were received from 140 individuals representing nine hospital departments. Eighty-three participants (59.3%) had previously received disaster education; 53 (37.9%) had attended a disaster simulation drill, and 18 (12.9%) had responded to an actual disaster. The average disaster preparedness knowledge score was 3.57 out of 10. The majority of respondents rated themselves as "not really" prepared and were "unsure" of their respective departments' level of preparedness. Most respondents indicated a willingness to participate in both a conventional incident involving burns and/or physical trauma, and an incident involving chemical, biological or radiological (CBR) weapons. Australian hospital staff are under-prepared to respond to a disaster because of a lack of education, insufficient simulation exercises, and limited disaster experience. The absence of specific national standards and guidelines through which individual hospitals can develop their capabilities further compounds the poverty in preparedness.